Arkansas Pupils’ Body Weights Add Up

A groundbreaking statewide study released last week evaluating the
body weights of nearly all public school students in Arkansas has found
that 38 percent of them are overweight or are at risk of becoming
overweight.

The study results, which are drawing national attention, have led
researchers in Arkansas to suggest that the problem of childhood
obesity may be even more common than federal figures show. The
government estimates that 31 percent of U.S. children are overweight or
at risk of becoming so.

"No area of the state has been spared from the epidemic of childhood
obesity," said Dr. Joseph W. Thompson, the director of the Arkansas
Center for Health Improvement, the independent health-care-policy
research center in Little Rock that conducted the study. "This study
clearly indicates that children of every age, gender, economic status,
and ethnic group across the state are vulnerable."

Researchers in Arkansas analyzed "body-mass index" data for more
than 345,000 students at all grade levels in 93 percent of the
state’s public schools during the 2003-04 school year. National
experts said it was the most comprehensive statewide survey of the
body-mass index of public school students ever conducted.

Based on the data, the researchers calculated that 21 percent of
students were overweight and that 17 percent were at risk of being
overweight.

The study used the federal government’s definition for
body-mass index, which is calculated by comparing a person’s
weight in relation to height. For example, a child who was 4 feet tall
and weighed 100 pounds would have a BMI of 30.5 and be considered
overweight. But a child of the same height who weighed 80 pounds would
have a BMI of 24.4, which is considered normal.

Statewide, the study found, 39 percent of boys and 37 percent of
girls were considered overweight or at risk for being overweight.

It also found that African-American girls and Hispanic boys had the
highest risk of being overweight. Forty-four percent of
African-American girls were found to be overweight or at risk of weight
problems, and 49 percent of Hispanic boys were in those categories.

Even though the trends are consistent with national estimates,
officials at the federal Centers for Disease Control and Prevention in
Atlanta cautioned that a statewide study is probably not representative
of the nation.

Deb Galuska, the associate director for science in the division of
nutrition and physical activity at the CDC, said state studies
generally do not represent the whole country because they may have
concentrations of subgroups that are prone to weight problems.

Even so, experts in Arkansas hope that their study will serve as a
model for other states.

Last year, Arkansas became the first state to enact legislation
requiring an annual BMI screening assessment for all students in public
schools starting in prekindergarten classes. Act 1220, which requires
schools to screen students and issue reports to parents, has been
promoted as a step forward in the fight against childhood obesity.

But the initiative has raised concerns among some health experts and
parents, who argue that such screening methods go beyond the role of
schools.

"It’s a problem weighing kids like this," said Frances Berg,
the author of Underage and Overweight, a book about childhood
obesity in the United States.

Ms. Berg said in an interview that focusing on a child’s
weight at school is an inappropriate means of dealing with obesity.
Screening in schools, if done in open areas such as gyms, she said, can
humiliate heavier children, hurt self- esteem, and potentially increase
eating disorders.

In addition, she pointed out, the body-mass index can inaccurately
cite athletic students as overweight. Athletes may naturally have a
higher BMI, because muscle weighs more than fat.

The study has elicited worries among Arkansas parents and caused
some local controversy, said Rosemary Rodibaugh, a food and nutrition
specialist with the University of Arkansas’ Division of
Agriculture- Cooperative Extension Service who is not connected with
the study.

"It’s very controversial because of the anecdotal evidence
presented by parents" of perceived problems with the program, she
said.

Parents are fearful of the labeling or rating of their children as
overweight, or may be confused over what the BMI means and wonder why
schools are notifying them about their children’s weight.

Some parents, according to Ms. Rodibaugh, have questioned the
results for children described as overweight because the parents
consider them to be thin or their doctors say the children are fine.
Letters with individual results were mailed to parents this
summer.

‘Seeing Heavier Kids’

Officials at the Arkansas Center for Health Improvement acknowledge
that the BMI screening is merely a tool, and they encourage parents to
seek confirmation from their family doctors. But they argue that weight
problems can often sneak up on people, and they say that many parents
don’t recognize when their children are at risk.

"It’s very hard for some people to tell if their child is
overweight because we’re getting used to seeing heavier kids,"
Ms. Rodibaugh said.

Dr. Peter LePort, a bariatric, or obesity, surgeon at Orange Coast
Memorial Medical Center in Fountain Valley, Calif., said that the
Arkansas study provides parents with important facts and confirms that
weight problems are on the rise.

However, he argued, the steps center officials are suggesting to
help solve the problem— cutting down on junk food, exercising
more, watching less television— oversimplify the situation.

"It’s a big leap at something that’s not proven," he
said of the emphasis on such causes.

The underlying problem, he contended, is that many children and
adolescents are bored, lack values, and have no sense that they need to
achieve. To fill the resulting void, he said, they eat too much or find
some other addiction.

Diet and exercise alone, he emphasized, will not cure the
problem.

Community Effort

Despite concerns and skepticism, the Arkansas study has garnered
support for the mandates of Act 1220. In addition to sending parents
letters on the screening results, the law’s provisions require
schools to disclose the details of food and beverage contracts and to
remove vending machines from elementary schools.

Gov. Mike Huckabee, a Republican, has announced that the state will
continue its efforts to combat childhood obesity by adding six
additional community health education specialists to help schools and
communities.

Individual schools are also making changes, according to officials
of the health-improvement center, and recommendations were presented to
the state board of education in June on how to help schools combat
obesity. Possible steps include limiting student access to food of low
nutritional value, offering staff members professional development on
nutrition and physical activities, and restricting beverage contracts
so that schools can sell only 12-ounce sodas.

"This is not just an educational challenge," the center’s Dr.
Thompson said. "And it’s not just a challenge for parents.
It’s a community challenge."

Vol. 24, Issue 3, Pages 1, 22

Published in Print: September 15, 2004, as Arkansas Pupils’ Body Weights Add Up

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